Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
Department of Obstetrics and Gynecology, Division of Urogynecology, Allegheny Health Network, Pittsburgh, Pennsylvania, United States of America.
PLoS One. 2022 Jun 16;17(6):e0269852. doi: 10.1371/journal.pone.0269852. eCollection 2022.
The COVID-19 pandemic disrupted medical care in the US, leading to a significant drop in utilization of some types of health services. We sought to quantify how the pandemic influenced obstetrics and gynecology care at two large health care organizations.
Comparing 2020 to 2019, we quantified changes to obstetrics and gynecology care at two large health care organizations in the United States, Allegheny Health Network (in western Pennsylvania) and Johns Hopkins University (in Maryland). The analysis considered the numbers of surgical encounters, in-person visits, and telemedicine visits. For each system, we quantified temporal changes in surgical volume, in-person and telemedicine visits, and financial impact related to professional fee revenues. We used segmented regression to evaluate longitudinal effects.
At both institutions, the volume of care was similar in the first few months of 2020 compared to 2019 but dropped precipitously in March 2020. From April to June 2020, surgical volumes were 67% of the same period in 2019 at Allegheny Health and 48% of the same period in 2019 at Johns Hopkins. During that same interval, televisits accounted for approximately 21% of all ambulatory care at both institutions. Although surgical and ambulatory volumes recovered in the second half of 2020, annual surgical volumes in 2020 were significantly lower than 2019 at both institutions (p<0.05) and 2020 ambulatory volumes remained significantly lower at Johns Hopkins (p = .0006). Overall, revenues in 2020 were 91% of 2019 revenues for both institutions.
Obstetrical and gynecologic ambulatory visits and gynecologic surgeries were sharply reduced during the COVID-19 pandemic. Although care volumes returned to 2019 levels in late 2020, we observed an overall reduction in the volume of care provided and a 9% reduction in professional revenue for both institutions.
COVID-19 大流行扰乱了美国的医疗服务，导致某些类型的医疗服务利用率显著下降。我们试图量化大流行如何影响两家大型医疗保健组织的妇产科护理。
我们将 2020 年与 2019 年进行比较，量化了美国两家大型医疗保健组织（宾夕法尼亚州西部的阿勒格尼健康网络和马里兰州的约翰霍普金斯大学）的妇产科护理变化。该分析考虑了手术次数、面对面就诊和远程医疗就诊。对于每个系统，我们量化了手术量、面对面和远程医疗就诊以及与专业费用收入相关的财务影响的时间变化。我们使用分段回归来评估纵向影响。
在这两个机构，2020 年头几个月的护理量与 2019 年相似，但 2020 年 3 月急剧下降。2020 年 4 月至 6 月，阿勒格尼健康的手术量为 2019 年同期的 67%，约翰霍普金斯的手术量为 2019 年同期的 48%。在此期间，两家医院的电视就诊量约占所有门诊护理的 21%。尽管手术和门诊量在 2020 年下半年有所恢复，但 2020 年的年度手术量明显低于两家医院 2019 年（p<0.05），而 2020 年约翰霍普金斯的门诊量仍明显低于 2019 年（p =.0006）。总的来说，2020 年两家医院的收入为 2019 年收入的 91%。
COVID-19 大流行期间，妇产科门诊和妇科手术大幅减少。尽管 2020 年末护理量恢复到 2019 年的水平，但我们观察到提供的护理量总体减少，两家医院的专业收入减少 9%。
